Efecto de la Dieta Mediterránea sobre los valores ambulatorios de la presión arterial en pacientes de alto riesgo cardiovascular

[spa] La Hipertensión arterial (HTA) sigue siendo el principal factor de riesgo implicado en el desarrollo de enfermedad coronaria, insuficiencia cardíaca congestiva, accidente cerebrovascular y enfermedad renal. Su prevalencia sigue aumentando exponencialmente debido a una mejor detección y un aumento de otros factores asociados como la obesidad, la inactividad física o la diabetes mellitus. Datos recientes estiman que la prevalencia de HTA aumentará al 37,3 % en 2030, extendiendo esta tendencia, incluso a países que tradicionalmente tienen un menor riesgo cardiovascular, como España. Estos datos alertan pues de la magnitud del problema y la necesidad de aumentar los esfuerzos para mejorar el diagnóstico, el tratamiento y, sobre todo, la prevención de la enfermedad hipertensiva. En las últimas décadas se ha incrementado la evidencia que apoya el potencial vasculoprotector de la dieta y sus diferentes nutrientes, siendo cada vez más sólida la evidencia sobre los beneficios de la llamada “Dieta Mediterránea”. La dieta mediterránea (DMed) se caracteriza por un patrón alimentario a base de alto consumo de frutas, verduras y grasas monoinsaturadas, situando al aceite de oliva como principal fuente de grasa. Actualmente el mayor grado de evidencia científica sobre los beneficios de la DMed provienen del estudio PREDIMED. Dicho estudio fue el primer ensayo clínico multicéntrico y aleatorizado que incluyó a 4.774 pacientes con alto riesgo cardiovascular en prevención primaria. Los pacientes fueron asignados a uno de tres grupos de una intervención dietética: DMed suplementadas con aceite de oliva virgen (AOVE), DMed complementa con frutos secos (FS), o una dieta baja en grasas control. Dicho estudio demostró con el máximo nivel de evidencia, que una DM complementado con en AOVE o FS reduce significativamente la incidencia de eventos cardiovasculares mayores, con un CR de 0,70 (95% CI, 0,54 - 0,92) y (IC 95%, 0,54-0,96) 0,72, respectivamente. Sin embargo, la mayor parte de los datos disponibles que evalúan el efecto de la DM sobre la presión arterial (PA) se han basado en la PA clínica, siendo éste un enfoque limitado por la mala reproducibilidad, el efecto de bata blanca así cómo el sesgo del observador y la variabilidad del paciente. La monitorización ambulatoria de la PA (MAPA) de 24 horas se considera el estándar de oro para la evaluación de los efectos de las intervenciones sobre la PA, ya que las mediciones repetidas reflejan con mayor precisión el verdadero valor de la PA, en comparación al valor de la PA clínica. Es por ello que el objetivo de nuestro estudio fue evaluar el efecto de una dieta de la DMed suplementada con AOVE o FS, en comparación con una dieta control baja en grasas, sobre los valores ambulatorios de PA (tanto diurnos como nocturnos) en individuos de alto riesgo cardiovascular, tras un año de intervención dietética, sin modificación de otros parámetros (dietéticos, ejercicio, pérdida de peso, terapia farmacológica antihipertensiva) con un marcado efecto sobre los valores de PA. Los datos de nuestro estudio, enmarcado dentro de la cohorte global del estudio PREDIMED, incluyó 235 sujetos (56,5% mujeres; edad media: 66,5 años) mostraron que la DMed complementada con AOVE o FS comportaban una reducción significativa de los valores ambulatorios de presión sistólica en comparación con una dieta de control en individuos con alto riesgo de enfermedad cardiovascular. Las diferencias netas entre los valores medios de PA ambulatoria entre la DMed suplementada con AOVE y FS y la dieta de control, fueron de -4,0 mmHg y -4.3 mmHG de PA sistólica respectivamente y de -1,9 mm Hg para el componente diastólico ( similar para ambos grupos suplementados frente al grupo control) después del ajuste de entre-dieta desequilibrios en la PA inicial y cambios en la medicación antihipertensiva. Si bien la magnitud del descenso ambulatorio de PA parece pequeña, el impacto podría ser notable a nivel poblacional.[eng] The PREvención con DIeta MEDiterránea (PREDIMED) trial showed that Mediterranean diets (MedDiets) supplemented with either extravirgin olive oil or nuts reduced cardiovascular events, particularly stroke, compared with a control, lower fat diet. The mechanisms of cardiovascular protection remain unclear. We evaluated the 1-year effects of supplemented MedDiets on 24-hour ambulatory blood pressure (BP), blood glucose, and lipids. Randomized, parallel-design, controlled trial was conducted in 2 PREDIMED sites. Diets were ad libitum, and no advice on increasing physical activity or reducing sodium intake was given. Participants were 235 subjects (56.5% women; mean age, 66.5 years) at high cardiovascular risk (85.4% with hypertension). Adjusted changes from baseline in mean systolic BP were −2.3 (95% confidence interval [CI], −4.0 to −0.5) mm Hg and −2.6 (95% CI, −4.3 to −0.9) mm Hg in the MedDiets with olive oil and the MedDiets with nuts,respectively, and 1.7 (95% CI, −0.1 to 3.5) mm Hg in the control group (P<0.001). Respective changes in mean diastolic BP were −1.2 (95% CI, −2.2 to −0.2), −1.2 (95% CI, −2.2 to −0.2), and 0.7 (95% CI, −0.4 to 1.7) mm Hg (P=0.017). Daytime and nighttime BP followed similar patterns. Mean changes from baseline in fasting blood glucose were −6.1, −4.6, and 3.5 mg/dL (P=0.016) in the MedDiets with olive oil, MedDiets with nuts, and control diet, respectively; those of total cholesterol were −11.3, −13.6, and −4.4 mg/dL (P=0.043), respectively. In high-risk individuals, most with treated hypertension, MedDiets supplemented with extravirgin olive oil or nuts reduced 24-hour ambulatory BP, total cholesterol, and fasting glucose

Service regulations, input prices and export volumes : evidence from a panel of manufacturing firms

Utilizando datos de panel, este trabajo muestra que una mejor regulación en el sector servicios reduce el precio de los consumos intermedios que soportan las empresas de manufacturas, especialmente aquellas de mayor tamaño. El beneficio de un marco regulatorio que fomenta la competencia en el sector servicios se extiende a los mercados internacionales. Entre 1991 y 2007, las reformas en servicios habrían permitido a las grandes compañías industriales españolas incrementar sus exportaciones reales de bienes alrededor de un 22 % en términos acumulados, a lo largo de este período, frente a un hipotético escenario sin reformas. Más aun, si se hubiera producido la convergencia en materia regulatoria al marco de mejores prácticas en 2007, el volumen de exportación de las grandes empresas hubiera sido un 10 % superior, en términos acumulados, frente al valor observado. No obstante, no se observa evidencia robusta de este efecto en el caso de las pymes. El estudio muestra que el tamaño de la empresa es relevante para estudiar el vínculo que existe entre las reformas regulatorias, los precios de los consumos intermedios y el volumen de exportaciónUsing a panel of firm-level data from Spanish manufacturers, this study shows that better service regulation reduces the price of intermediate inputs paid by downstream firms. The beneficial cost effects of services reforms extend to both large and small-to-medium sized corporations (SMEs), but the former tend to enjoy greater gains. This feature also manifests itself in international markets. We identify an input cost channel through which service regulations affect the volume of exports of large manufacturers, while the evidence of such channel is weaker for SMEs. Our estimates indicate that, from 1991 till 2007, large firms increased their volume of exports by an average of 22% as a result of the direct input cost effect of services reforms, such that the firms that benefited the most typically belonged to industries more dependent on service inputs. Furthermore, convergence to the “best practice” regulatory framework in services would have raised exports at least by an additional 10%. We conclude that firm size is relevant for the connection between services reforms, intermediate input prices and export volume

Relationship between Mediterranean Dietary Polyphenol Intake and Obesity

Abstract: Obesity is a multifactorial and complex disease defined by excess of adipose mass and constitutes a serious health problem. Adipose tissue acts as an endocrine organ secreting a wide range of inflammatory adipocytokines, which leads to systemic inflammation, insulin resistance, and metabolic disorders. The traditional Mediterranean diet is characterized by a high phenolic-rich foods intake, including extra-virgin olive oil, nuts, red wine, vegetables, fruits, legumes, and whole-grain cereals. Evidence for polyphenols' effect on obesity and weight control in humans is inconsistent and the health effects of polyphenols depend on the amount consumed and their bioavailability. The mechanisms involved in weight loss in which polyphenols may have a role are: activating β-oxidation; a prebiotic effect for gut microbiota; inducing satiety; stimulating energy expenditure by inducing thermogenesis in brown adipose tissue; modulating adipose tissue inhibiting adipocyte differentiation; promoting adipocyte apoptosis and increasing lipolysis. Even though the intake of some specific polyphenols has been associated with body weight changes, there is still no evidence for the effects of total polyphenols or some polyphenol subclasses in humans on adiposity. Keywords: dietary intake; catechins; resveratrol; olive oil; wine; BM

Effects of a Novel Nutraceutical Combination (Aquilea Colesterol®) on the Lipid Profile and Inflammatory Biomarkers: A Randomized Control Trial

Background: Cholesterol-lowering nutraceuticals are useful in the management of moderate hypercholesterolemia. Methods: In a parallel-group, randomized, placebo-controlled double-blind trial we evaluated the effects on plasma total cholesterol, low-density lipoprotein cholesterol (LDL-c), and inflammatory biomarkers of a nutraceutical combination (Aquilea Colesterol®) containing phytosterols (1.5 g), red yeast rice providing monacolin K (10 mg), hydroxytyrosol (5 mg), and plasma cholesterol values >5.17 mmol/L (>200 mg/dL) and LDL-c >2.97 mmol/L (>115 mg/dL). At baseline and at one and three months we recorded dietary habits; anthropometric parameters; blood pressure; lipid profile; fasting glucose; liver, renal, and muscle function tests, C-reactive protein (hs-CRP); and interleukin-6. Results: 13 men and 27 women (mean age 61.8 years) completed the trial; 20 participants received the nutraceutical and 20 received placebo. No adverse effects were noted. Compared to placebo, at one and three months the nutraceutical reduced total cholesterol by 11.4% and 14.1%, LDL-c by 19.8% and 19.7%, and apolipoprotein B by 12.4% and 13.5%, respectively (p < 0.001; all). hs-CRP decreased significantly (p = 0.021) in the nutraceutical group. Conclusion: The nutraceutical Aquilea Colesterol® is useful for reducing total cholesterol, LDL-c, and inflammation in individuals with moderate hypercholesterolemia

La huella ecológica corporativa de los materiales : aplicación al sector comercial

La huella ecológica es un indicador de sostenibilidad de índice único, desarrollado por Rees y Wackernagel en 1996, que mide todos los impactos que produce una población, expresados en hectáreas de ecosistemas o “naturaleza”. Utilizada habitualmente para regiones o países (…) hemos constatado que dicho indicador podía utilizarse también en las empresas y en cualquier tipo de organización (Doménech, 2006). En este trabajo se calcula la Huella Ecológica Corporativa de una empresa del sector comercial, concretamente un concesionario de automóviles del este español, a partir de los consumos anuales efectuados por la empresa. A continuación se recalculan determinados índices para la conversión de consumo de materiales a hectáreas, siguiendo la misma metodología empleada por J.L. Doménech en el cálculo de la huella de la Autoridad Portuaria de Gijón. Finalmente se proponen nuevos índices en sustitución de los anteriores y se diseña una nueva herramienta (hoja de cálculo) para el cálculo de la Huella Ecológica Corporativa.The ecological footprint is a sustainability indicator of unique index, developed by Rees and Wackernagel in 1996, which weighs up the impacts of a population on the Earth in terms of hectares of ecosystems or “nature”. The ecological footprint is habitually utilized for regions or countries (…) but can also be used for corporations and any other type of organization (Domenech, 2006). In this paper, the Corporative Ecological Footprint is calculated for a commercial corporation, concretely a car dealership of the eastern coast of Spain, from its annual consumption. Next, some indices to convert consumption of energy and materials into hectares are recalculated following the methodology employed by Domenech (2006) for the Port Authority of Gijón. Finally, some new indices are proposed in substitution of the previous ones and a new tool (an EXCEL sheet) is designed to calculate the Corporative Ecological [email protected] [email protected]

Beer Polyphenols and Menopause: Effects and Mechanisms-A Review of Current Knowledge

Beer is one of the most frequently consumed fermented beverages in the world, and it has been part of the human diet for thousands of years. Scientific evidence obtained from the development of new techniques of food analysis over the last two decades suggests that polyphenol intake derived from moderate beer consumption may play a positive role in different health outcomes including osteoporosis and cardiovascular risk and the relief of vasomotor symptoms, which are commonly experienced during menopause and are an important reason why women seek medical care during this period; here, we review the current knowledge regarding moderate beer consumption and its possible effects on menopausal symptoms. The effect of polyphenol intake on vasomotor symptoms in menopause may be driven by the direct interaction of the phenolic compounds present in beer, such as 8-prenylnaringenin, 6-prenylnaringenin, and isoxanthohumol, with intracellular estrogen receptors that leads to the modulation of gene expression, increase in sex hormone plasma concentrations, and thus modulation of physiological hormone imbalance in menopausal women. Since traditional hormone replacement therapies increase health risks, alternative, safer treatment options are needed to alleviate menopausal symptoms in women. The present work aims to review the current data on this subject

The ecological footprint of port authorities and services.

RESUMEN. En este articulo se presenta el análisis de los principales resultados del cálculo de la huella ecológica y de la huella de carbono (o emisiones de CO2 a la atmósfera), que se produce por la actividad económica de una Autoridad Portuaria de la Fachada Norte de España, además, se realizará una comparación de los resultados obtenidos con los de la Autoridad Portuaria de Gijón en el año 2006. Señalar que para las Autoridades Portuarias españolas la protección del medio ambiente y el desarrollo sostenible constituyen un compromiso y Forman parte de sus actuaciones estratégicas. También se realiza el cálculo, la comparación y el análisis de los resultados de algunos indicadores de ecoeficiencia de las empresas objeto de estudio. Para terminar el artículo, se pretende realizar aportaciones a la metodología de cálculo aplicada para la obtención de la huella ecológica de los servicios que contratan las empresas

Reliability and Concurrent and Construct Validity of a Food Frequency Questionnaire for Pregnant Women at High Risk to Develop Fetal Growth Restriction

Accuracy of dietary assessment instruments such as food frequency questionnaire (FFQ) is crucial in the evaluation of diet-disease relationships. Test-retest reliability and concurrent and construct validity of a FFQ were evaluated in 150 pregnant women at high risk to develop fetal growth restriction randomly selected from those included in the improving mothers for better prenatal care trial Barcelona (IMPACT BCN). The FFQ and dietary records were performed at baseline and 34-36 weeks of gestation. Test-retest reliability of the FFQ for 12 food groups and 17 nutrients was moderate (ICC = 0.55) and good (ICC = 0.60), respectively. Concurrent validity between food, nutrients and a composite Mediterranean diet score (MedDiet score) and food records was fair for foods and nutrients (ρ average = 0.38 and 0.32, respectively) and moderate (r = 0.46) for the MedDiet score. Validation with biological markers ranged from poor (r = 0.07) for olives to moderate (r = 0.41) for nuts. A fair concordance between methods were found for nutrients (weighted κ = 0.22) and foods (weighted κ = 0.27). The FFQ-derived MedDiet score correlated in anticipated directions with intakes of nutrients and foods derived by food records. The FFQ showed a moderate test-retest reliability and reasonable validity to rank women according to their food and nutrient consumption and adherence to the Mediterranean diet

The Corporative Footprint: Concept and Application to Two Galician Fishing Companies

Texto dispoñible en galego e españolA pegada ecolóxica (PE) é un indicador de sustentabilidade que proporciona un marco de referencia para a análise da demanda humana de bioprodutividade. Aplicado inicialmente aos territorios, está a lograr recentemente unha notable difusión como indicador aplicable ás empresas e, en xeral, ás organizacións. Neste artigo realizamos, en primeiro lugar, a descrición xeral do indicador, explicando os seus obxectivos e o método de cálculo, ademais de sinalar os principais puntos fortes e febles. Posteriormente, incidimos nas especificidades da PE das organizacións, realizando unha aplicación a dúas empresas do sector pesqueiro galego no ano 2006. Os resultados amosan diferenzas importantes nas dúas pegadas calculadas, identificando o consumo de enerxía e os cebos como as áreas principais causantes da pegada e das diferenzas existentesLa huella ecológica (HE) es un indicador de sustentabilidad que proporciona un marco de referencia para el análisis de la demanda humana de bioproductividad. Aplicado inicialmente a territorios, está logrando recientemente una notable difusión como indicador aplicable a empresas y, en general, a organizaciones. En este artículo realizamos, en primer lugar, la descripción general del indicador, explicando sus objetivos y el método de cálculo, además de señalar los principales puntos fuertes y débiles. Posteriormente, incidimos en las especificidades de la HE de las organizaciones, realizando una aplicación a dos empresas del sector pesquero gallego en el año 2006. Los resultados muestran diferencias importantes en las dos huellas calculadas, identificando el consumo de energía y los cebos como las áreas principales causantes de la huella y de las diferencias existentesThe ecological footprint (EF) is a sustainability indicator which provides a referential framework for the analysis of human demand for bioproductivity, including energy issues. Even though footprint analysis was mainly thought from a territory point of view, it can be also applied to companies and, in general, organizations. In this paper, we develop a general description of the indicator, pointing out its objectives and calculation method. In addition, footprint’s strengths and weaknesses are also stated. We also remark the particularities of organization’s footprints, applying the indicator to two Galician fishing companies. Results show important differences between the studied companies, being able to identify energy and fish feed consumptions as the main responsible of both the EF and the differences between companiesS

Rationale and design of the school-based SI! Program to face obesity and promote health among Spanish adolescents: A cluster-randomized controlled trial

Unhealthy habits in adolescents are increasing at an alarming rate. The school offers a promising environment in which to implement effective preventive strategies to improve adolescents' lifestyle behaviors. The SI! Program is a multilevel multicomponent school-based health-promotion intervention aimed at all stages of compulsory education in Spain. We present the study design of the SI! Program for Secondary Schools, targeting adolescents aged 12 to 16 years. Aim: The main goal of this study is to evaluate the impact of the SI! Program educational intervention on adolescent lifestyle behaviors and health parameters. Methods: The study was designed as a cluster-randomized controlled intervention trial and enrolled 1326 adolescents from 24 public secondary schools in Spain, together with their parents/caregivers. Schools and their students were randomly assigned to the intervention group (the SI! curriculum-based educational program over 2 or 4 academic years) or to the control group (usual curriculum). The primary endpoint will be the change from baseline at 2-year and 4-year follow-up in the composite Ideal Cardiovascular Health (ICH) score, consisting of four health behaviors (body mass index, dietary habits, physical activity, and smoking) and three health factors (blood pressure, total cholesterol, and glucose). Secondary endpoints will include 2-year and 4-year changes from baseline in ICH score subcomponents, the Fuster-BEWAT health scale, adiposity markers (waist circumference and body composition), polyphenol and carotenoid intake, and emotion management. Discussion: The overarching goal of the SI! Program is to instill healthy behaviors in children and adolescents that can be sustained into adulthood. The SI! Program for Secondary School is a comprehensive health-promotion intervention targeting 12-16-year-old adolescents and their immediate environment. The present study addresses the optimal timing and impact of the educational intervention on health in adolescence